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Imperative for US leadership in global response to Zika

As we await warmer temperatures and the arrival of the Aedes aegypti mosquito carrying the Zika virus to our shores, the U.S. government is accelerating its domestic preparedness and response activities. These critical activities include improving surveillance and laboratory capacity, educating health care workers and the general public, and accelerating vaccine research.

An equally important role for the U.S. is to support the response of other countries in the Americas, both directly and indirectly, through multinational institutions such as the World Health Organization (WHO).  This is essential when dealing with infectious disease epidemics originating abroad because the best way to protect the American people is always to stop an outbreak at its source.  While in this case the Zika virus disease cannot be contained, a forward leaning U.S. global engagement strategy is important from both a humanitarian and national security perspective.

{mosads}Two examples provide important insights for how we should approach our international response to Zika.  First, the West African Ebola epidemic of 2013-2014 demonstrated that the WHO did not have the operational capacity, governance, or mechanisms of accountability to ensure that member countries promptly reported and responded to outbreaks.  A recent report, led by the Harvard Global Health Institute and the London School of Hygiene & Tropical Medicine and focused on the global response to Ebola, recommended a number of good governance reforms, assertive leadership, and more targeted financing of WHO to prepare for future public health emergencies.

In Zika, we see the WHO trying to learn from the lessons of the Ebola outbreak.  On February 1, the organization declared that clusters of birth defects associated with Zika infection during pregnancy constitute a “public health event of international concern” and shortly thereafter released a Strategic Response Framework and Joint Operations Plan to support affected countries.  The administration’s recent FY17 budget request for the WHO is approximately $113 million.  Congress should ensure that the WHO’s framework and plan maximally align with and complement U.S. preparedness and response activities.

A second example that can guide the U.S. international response to Zika is the President’s Emergency Plan for AIDS Relief (PEPFAR).  PEPFAR was launched by President George W. Bush and its beneficial health impacts over the last decade are indisputable: it has reduced the deaths from HIV and AIDS, literally saving millions of lives by providing critical access to anti-retroviral treatments for men, women, and children in sub-Saharan Africa.  A critical additional benefit of this program, as documented in the Bipartisan Policy Center’s report on strategic health diplomacy, is that it may have boosted the public opinion in those countries of the U.S., fueled socio-economic development, and generated greater political stability.  All of this is in line with U.S. national security interests.

The administration’s current emergency request for USAID and the State Department’s response to Zika in Latin American countries focuses on integrated vector (mosquito) management, market incentives to spur vaccine and diagnostics innovations, support of health care worker training, support for pregnant women’s health, and the establishment of educational campaigns to empower communities to take actions to protect themselves. In addition, Congress should look broadly at the Family Planning and Reproductive Health budgets of USAID and the State Department’s Global Health Program to ensure women of childbearing age have access to voluntary family planning information.

As with the example of PEPFAR, effective global health programs targeted to Latin American countries will be positive for the region and the U.S.  This is particularly true for several Central American countries where gang violence, international crime, drug trafficking, and corruption have stymied economic progress and partly resulted in migration towards our borders.  Preventing disease and promoting health are critical to increasing educational and employment opportunities for citizens in these countries. Finally, support for affected countries will only deepen ties with allies and friendly governments in the region, including Brazil, which is a particularly important strategic ally.

We believe that the U.S. has an opportunity, working with the World Health Organization, to improve the health and welfare of countries in the Americas through its response to the Zika virus.  A strong, committed global health engagement strategy is good foreign policy as well.  Generating goodwill amongst our allies and neighbors will make it more likely that they work with us on other important bilateral issues. This is what strategic health diplomacy is all about. It’s time to take this concept out of the toolbox and witness its ability to do good in the world.

Parekh is senior adviser at the Bipartisan Policy Center and former deputy assistant secretary of Health at the Department of Health and Human Services. Jha is the K.T. Li professor of International Health and director of the Harvard Global Health Institute. 


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